Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05690 | Date 06/07/2019 |
| Token No | SM/19-20/6016 06/07/2019 | Serial | 079 Last Visit: 06/07/2019 |
| Patient Name | Master TEJAS DAS | Contact No | 9903253617 |
| Address | 49 CHATRA POTI PARA,BAIDYABATI(M) | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||